Child psychiatric disorder and relative age in school year: Peer effects need to be considered

doi:10.1136/bmj.327.7426.1287

BMJ 2003;327:1287 (29 November), doi:10.1136/bmj.327.7426.1287

Letter

Child psychiatric disorder and relative age in school year

Peer effects need to be considered

The first 150 words of the full text of this article appear below.

EDITOR—Goodman et al show clearly how small effects atan individual level can create opportunities at the populationlevel for public health interventions.¹ As they say, the differentialbehaviour of teachers towards slightly younger pupils in theclassroom may increase their risk of developing mental healthproblems. However, there are other players learning their partsin the classroom drama: the older children.

As professionals and adults it is easy for us to neglect thelong term impact of early social adversity,² but patterns ofbullying and sexual aggression can undermine mental wellbeingin the school age population. At 5, if there are going to betargets for classroom bullying, the younger (smaller, less articulate,less assertive) child may be at greatest risk. At 11 and older,the young people who reach puberty first may show aggressiontowards their less developed classmates.

Most children do not experience trauma during . . . [Full text of this article]

Woody Caan, professor of public health

Department of Public and Family Health, APU, Chelmsford, Essex CM1 1SQ a.w.caan@apu.ac.uk

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